Citation Nr: 18144322
Decision Date: 10/24/18	Archive Date: 10/24/18

DOCKET NO. 13-24 433
DATE:	October 24, 2018
REMANDED
Entitlement to service connection for chronic fatigue syndrome is remanded.
Entitlement to an initial compensable rating for irritable bowel syndrome (IBS) is remanded.
REASONS FOR REMAND
The Veteran had active service from November 1990 to May 1991, including service in the Southwest Asia theater of operations from January 1991 to April 1991.
These matters are before the Board of Veterans’ Appeals (Board) on appeal from a rating decision of a Department of Veterans Affairs (VA) Regional Office (RO).
In January 2017, the Veteran testified before the undersigned Veterans Law Judge (VLJ) at a video conference hearing.  A transcript of her testimony is of record.
These matters were previously before the Board in September 2017, when they were remanded for additional development. 

1. Entitlement to service connection for chronic fatigue syndrome is remanded.
2. Entitlement to an initial compensable rating for IBS is remanded.
The evidence indicates there may be outstanding relevant VA treatment records.  A November 8, 2017 VA treatment record indicates that the Veteran was to return for a follow up appointment on December 20, 2017.  VA treatment records subsequent November 9, 2017 have not been associated with the claims file.  Additionally, VA treatment records from April 14, 2015 and April 15, 2015 indicate that records had been scanned into VistA Imaging.  It does not appear these records have been associated with the claims file.  A remand to obtain the outstanding records is required. 
The claims file indicates that the Veteran receives ongoing services from VA vocational rehabilitation.  To date, the Veteran’s vocational rehabilitation folder has not been associated with the record.  Accordingly, on remand the Veteran’s complete VA vocational rehabilitation counseling folder, to include all evaluations and narrative reports, should be obtained.
Regarding the Veteran’s claim for chronic fatigue syndrome, while a VA opinion was obtained in November 2017, the examination report is not fully responsive to the September 2017 remand directives.  Specifically, the examiner did not address whether the Veteran’s claimed fatigue represented an undiagnosed illness. Thus, an addendum opinion is required. 
The matters are REMANDED for the following actions:
1. Ask the Veteran to provide the names and addresses  of all medical care providers who have recently treated him for her claimed disabilities. After securing any necessary releases, request any relevant records identified.  In addition, obtain updated VA treatment records and the VistA Imaging record referenced in      the April 14, 2015 and April 15, 2015 VA treatment records.  If any requested records are unavailable, the Veteran should be notified of such.
2. Obtain and associate the Veteran’s complete VA vocational rehabilitation counseling folder, to include    all evaluations and narrative reports. If the records are not available, the claims file should be annotated to reflect such and the Veteran notified of such.
3. After the above is completed to the extent possible, forward the claims file to a VA clinician to obtain an addendum opinion regarding the Veteran's claimed fatigue.  If an examination is deemed necessary to respond to the questions presented, one should be scheduled.  Following review of the claims file, the clinician should opine whether it is at least as likely        as not (50 percent probability or greater) that the Veteran’s claimed fatigue represents an undiagnosed illness related to her Persian Gulf War service? Please explain why or why not.  A complete rationale should    be provided for all opinions and conclusions expressed.
 
K. A. BANFIELD
Veterans Law Judge
Board of Veterans’ Appeals
ATTORNEY FOR THE BOARD	J. Anderson